HORMONAL STUDIES OF A BENIGN INTERSTITIAL CELL TUMOUR OF THE TESTIS PRODUCING ANDROSTENEDIONE AND TESTOSTERONE

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Abstract
A case is described of a 14-year old male who presented with precocious puberty resulting from a benign slow growing interstitial cell tumor of the testis. Preoperative studies revealed a marked increase in urinary 17-ketosteroids, pregnanetriol and testosterone glucuronide. The urinary steroids showed little change following corticotrophin stimulation, dexamethasone suppression or chorionic gonadotrophin stimulation demonstrating the autonomous nature of this tumor. Although the urinary testosterone glucuronide levels were markedly elevated, the plasma levels of testosterone were normal and androstenedione elevated. These findings are in accord with in vitro findings of this tumor and support the premise that 1 of the primary metabolic products of this tumor was androstenedione which was peripherally transformed to testosterone glucuronide which was then excreted in the urine. The elevated 17-hydroxycorticosteroids and pregnanetriol, which returned to normal following removal of the tumor, together with the absence of any crystalloids of Reinke, suggest that the tumor may be of a biologically primitive cell type or of adrenal rest origin.

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